SenseCheQ: Community-Based Sensory Testing for Early Identification of Chemotherapy Induced Peripheral Neuropathy

Chemotherapy induced painful neuropathy (CIPN) is a debilitating side effect experienced by 30-40,000 patients each year in the UK. This chronic pain condition is a major burden on patients impacting deeply on the quality of their survivorship. Unfortunately, by the time the patient reports their pain, irreversible neural damage has already occurred.  Quantitative Sensory Testing (QST) utilizes defined stimuli to elicit percepts to objectively measure thermal and mechanical sensitivity of the skin. These measures have demonstrated profiles of abnormalities associated CIPN. Unfortunately, QST is time consuming, requires hospital visits and specialist equipment/trained personnel and is rarely deployed in routine clinical care. This prevents longitudinal testing of patients which could reveal pre-clinical signs of developing neuropathy enabling intervention prior to the development of pain. Instead, clinicians rely on bedside sensory tests and subjective symptom scoring scales delivered in clinic which leads to delayed recognition of any sensory problems meaning chemotherapy dose reduction (which is an integral part of many existing regimes) is implemented too late.

Our proposal will develop a “Pain Patch” wearable that can be used in the community. A thin, flexible parylene substrate will house thermal, mechanical and electrical stimulation modules that will be developed independently. Early iterations will utilize “off the shelf” components to build a benchtop version. This pilot approach, with micro Peltier elements and piezo actuators, to deliver thermal and vibration stimuli will demonstrate proof of concept. Battery power solutions and wireless data acquisition / transmission modules with an app based controller will complement the stimulation modules. These systems will be tested in healthy volunteers (with topical sensitization / local anaesthesia to mimic neuropathy) head-to-head with conventional QST equipment. Subsequent iterations will integrate these modules into small, cheap self-contained patches that will be tested in a proof of concept trial in patients undergoing chemotherapy treatment.